Abstract
After noting the fundamental differences between the agenda of ordinary psychotherapy and the treatment of post-traumatic stress disorder (PTSD), the paper discusses the concept of trauma vis-à-vis PTSD using Yalom's (1981) four existential themes of death, freedom, isolation, and meaninglessness as organizing principles. The middle section of the paper focuses on the role of dissociation in the symptomatology of PTSD, suggesting, among other things, that many PTSD symptoms are dissociative in nature; that it is a defense against both memories of the event and the experience itself. Research is reviewed supporting the connection between PTSD and hypnotizability and the use of hypnosis in treating traumatic stress is discussed followed by two case examples. The latter section focuses on the limitations of hypnosis, transference considerations, and ends with a summary of the author's eight “C's” treatment approach: confront, condensation, confession, consolation, consciousness, concentration, control, and congruence.
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References
American Psychiatric Association. (1980).Diagnostic and Statistical Manual of Mental Disorders (third edition), Washington, D.C.
As, A. (1962). Nonhypnotic experiences related to hypnotizability in male and female college students.Scand. J. Psychol. 3: 47–64.
Bower, G. H. (1971). Mood and memory.Am. Psychologist 36: 129–148.
Brende, J. O., and Benedict, B. D. (1980). The Vietnam combat delayed response syndrome: Hypnotherapy of dissociative symptoms.Am. J. Clin. Hypnosis 23: 34–40.
Brett, E. A., and Ostroff, R. (1985). Imagery and post-traumatic stress disorder: An overview.Am. J. Psychiat. 142: 417–424.
Erdelyi, M. H., and Kleinbard, J. (1978). Has Ebbinghaus decayed with time? The growth of recall (hypermnesia) over days.J. Exp. Psychol. Hum. Learn. Mem. 4: 275–289.
Frankl, V. E. (1965).The Doctor and the Soul Knopf, New York.
Freud, A. (1946).The Ego and Mechanisms of Defense International Universities Press, New York.
Freud, S. (1958).The Standard Edition of the Complete Psychological Works of Sigmund Freud, XII, 1914 (transl. J. Strachey), The Hogarth Press and Institute of Psychoanalysis, London.
Frischholz, E. J. (1985). The relationship among dissociation, hypnosis, and child abuse in the development of multiple personality disorder. In Kluft, R. P. (ed.),Childhood Antecedents of Multiple Personality American Psychiatric Press, Washington, D.C.
Haley, S. A. (1974). When the patient reports atrocities.Arch. Gen. Psychiat. 30: 191–196.
Haley, S. A. (1978). Treatment implications of post-combat stress response syndrome for mental health professionals. In Figley, C. R. (ed.),Stress Disorders among Vietnam Veterans Brunner/Mazel, New York.
Hilgard, J. R. (1970).Personality and Hypnosis: A Study of Imaginative Involvement University of Chicago Press, Chicago.
Horowitz, M. J. (1979).States of Mind Plenum, New York.
Horowitz, M. J., and Solomon, G. F. (1978). A prediction of stress response syndromes in Vietnam veterans. In Figley, C. R. (ed.),Stress Disorders among Vietnam Veterans Brunner/Mazel, New York.
Kardiner, A., and Spiegel, H. (1947).War Stress and Neurotic Illness Paul Hoeber, Inc., New York.
Kluft, R. P. (1984). Treatment of multiple personality disorder. In Braun, B. G. (ed.),Multiple Personality. Psychiatric Clinics of North America, Vol. 7, Saunders, Philadelphia, pp. 9–29.
Kovic, R. (1976).Born on the Fourth of July McGraw-Hill, New York.
Krystal, H. (1978). Self representation and the capacity for self-care. InAnnual of Psychoanalysis, Vol. 6, International Universities Press, New York, pp. 209–246.
Lifton, R. J. (1967).Death in Life: Survivors of Hiroshima Random House, New York.
Lifton, R. J. (1973).Home From the War Simon and Schuster, New York.
Lindemann, E. (1944). Symptomatology and management of acute grief.Am. J. Psychiat. 101: 141.
Morgan, A. M., and Hilgard, E. R. (1973). Age differences in susceptibility to hypnosis.Int. J. Clin. Exp. Hypnosis 21: 78–85.
Nemiah, J. (1985). Dissociative disorders. In Kaplan, H. I., and Sadock, B. I. (eds.),Comprehensive Textbook of Psychiatry, Vol. IV, Williams and Wilkins, Baltimore.
Putnam, F. W. (1985). Dissociation as a response to extreme trauma. In Kluft, R. P. (ed.),Antecedents of Multiple Personality American Psychiatric Press, Washington, D.C.
Sanders, S. (1986). The perceptual alteration scale: A scale measuring dissociation.Am. J. Clin. Hypnosis 29: 95–102.
Shor, R. E. (1960). The frequency of naturally occurring hypnotic-like experiences in the normal college population.Int. J. Clin. Exp. Hypnosis 8: 151–163.
Spiegel, D. (1981). Vietnam grief work using hypnosis.Am. J. Clin. Hypnosis 24: 33–40.
Spiegel, D. (1984). Multiple personality as a post-traumatic stress disorder. In Braun, B. G. (ed.),Multiple Personality: Psychiatric Clinics of North America, Vol. 7, Saunders, Philadelphia, pp. 101–110.
Spiegel, D., Hunt, T., and Dondershine, H. E. (1988). Dissociation and hypnotizability in post-traumatic stress disorder,Am. J. Psychiat. In press.
Spiegel, H. (1959). Hypnosis and transference: A theoretical formulation.Arch. Gen. Psychiat. 1: 634–639.
Spiegel, H., and Spiegel, D. (1978).Trance and Treatment: Clinical Issues of Hypnosis Basic Books, New York.
Stutman, R. D., and Bliss, E. L. (1985). Post-traumatic stress disorder, hypnotizability and imagery.Am. J. Psychiat. 142: 741–743.
Tellegen, A., and Atkinson, G. (1974). Openness to absorbing and self-altering experience (“absorption”), a trait related to hypnotic susceptibility.J. Abnorm. Psychol. 83: 268–277.
Veterans Administration, Department of Medicine and Surgery (1972).The Vietnam Veteran in Contemporary Society: Collected Materials Pertaining to the Young Veterans U.S. Government Printing Office, Washington, D.C., No. 5100-0057, LV-31.
Weitzenhoffer, A. M. (1980). Hypnotic susceptibility revisited.Am. J. Clin. Hypnosis 22: 130–146.
Weitzenhoffer, A. M., and Hilgard, E. R. (1962).Stanford Hypnotic Susceptibility Scale: Form C Consulting Psychologists Press, Palo Alto, Calif.
Wilbur, C. B. (1984). Multiple personality and child abuse. In Braun, G. B. (ed.),Multiple Personality. Psychiatric Clinics of North America, Vol. 7, Saunders, Philadelphia, pp. 3–8.
Yalom, I. D. (1981).Existential Psychotherapy Basic Books, New York.
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Spiegel, D. Dissociation and hypnosis in post-traumatic stress disorders. J Trauma Stress 1, 17–33 (1988). https://doi.org/10.1007/BF00974904
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DOI: https://doi.org/10.1007/BF00974904